Certifying Death

Question 1

What should be done before confirming a death?

Answer 1

Check resuscitation status
Read the patient notes
Explain the need to confirm the death to the relatives.

Question 2

How is a death confirmed?

Answer 2

Check patient’s ID

Document clearly in notes:
General appearance- skin colour, signs of life
Respiratory effort
Verbal stimuli response
Pain stimuli response
Assess pupils- fixed and dilated in death
Feel for carotid artery pulse
Auscultation- listen for heart sounds and breath sounds for 2 minutes

Question 3

Who can confirm a death?

Answer 3

Any trained health care professional

Question 4

Who can certificate a death?

Answer 4

Any doctor who has cared for the patient recently

Question 5

Describe what things must be present on the death certificate

Answer 5

Personal details
When they were last seen alive by you
Who saw them after death
If cause of death was identified by post-mortem
Part 1= cause of death (+ a,b,c= diseases that lead to death)
Part 2= conditions attributing to death
Your details- signature, GMC number, qualification, consultant’s name

Counterfoil- stays in the book

On the back- if they have been referred to the coroner, if waiting for investigations eg. histology

Question 6

Give 5 reasons why a death may be referred to the coroner

Answer 6

Unknown cause of death 
Sudden or unexpected death 
Not seen by doctor within 14 days pre-death 
Suspicious death 
Accidental/neglectful death 
Death due to prior employment 
Death due to an abortion 
Death during an operation or before recovering from anaesthetic
Possible suicide 
Death shortly after police custody

Question 7

What additional checks are required on a cremation form?

Answer 7

Check there are no implantable devices that will explode in the crematorium

Needs to be checked by the doctor treating the deceased and by a 2nd fully independent doctor.